Paul's Heart

Life As A Dad, And A Survivor

Archive for the category “Cancer”

Crossroads


The commercials and advertisements are unavoidable.  Drug companies pushing their latest “cures” for maladies from obesity to depression to erectile dysfunction.    There is a pill for everything.  No matter what illness we suffer from, our eyes light up when someone tells us that we can feel better.  We should feel better.  We can be made better.  Our attentions have been grabbed.

And then in true commercialization fashion, just as would occur in a car sale ad, a list of conditions is rattled off quickly and at the end of the advertisement, because by that time, the only thing that we are paying attention to, is that we will be cured.  But for those who do realize that there can be complications by taking the particular drug, there is an epic battle determining which is more important, quantity or quality of life.

Manage or even eliminate your pain, but the risk exists for developing lymphoma.  Treating depression might just result in increasing the risk of committing suicide which makes no sense to me as that is one of the major reasons you start taking an antidepressant – to avoid getting to that point of wanting to take your own life.  Every drug carries its own list of possible side effects to weigh and balance the difference of the benefits of taking the drug or taking the chance of letting the body do what it does naturally.  But seriously, when a health crisis is bad enough, we are then forced to decided if it will be worth the risk of developing heart issues, liver and kidney problems, skin dilemmas, and so on.

And this is only what you are made aware of what happens.  In my Paul’s Heart page “Are You Out Of Your Mind,” I told the story of a side effect that had not been listed for a drug that I was told that I had to take following my heart surgery back in 2008.  I explained that of all the side effects publicly listed, there are those side effects that do occur, that unless they met a certain occurrence level, the side effects will not get listed because it is not required due to low occurrence.  That does not mean that they did not exist.  The pressure is turned on to the patient to educate themselves on what has happened to their body.  Simply put, if you take anything that is meant to change something occurring with your body, that means it will affect other physiological systems of your body.  Even a simple aspirin comes with some side effect.

But when you absolutely, positively need the drug to save your life, whether it be cardiac or cancer to name just two issues, it may seem like a simple decision to make, and an obvious decision to make.  But when the results are not guaranteed, and risks are increased and raised severely, the issue becomes a matter of quality of life, versus the quantity of life.

In my Hodgkin’s Lymphoma situation, the exact details of what could happen with me were not known.  But there were some risks of developing side effects that were known.  Those risks were very vague and general, but the warnings were there.  Drugs in my chemotherapy regimen were actually given to counteract the side effects of one drug and so on.  I took the main drug of course to battle the cancer, but then took another drug to help build back the muscle loss caused by the chemotherapy.  But that drug needed medication to prevent and help to protect the kidneys that would be affected.  In my case, my decision was still a no-brainer.  The cure rate for Hodgkin’s did not lie, and I was not going to accept in my mind, anything less than hearing the words remission.

I got “lucky”.  Okay, that may not be an accurate term as many would not describe my last five years as being lucky given the issues that developed late from my cancer treatments decades ago.  In the case of my father, it is going to be a totally different situation.

Six months before he faced half of his lung to be removed due to cancer, my dad had a carotid artery cleaned out that had been narrowed due his dietary and smoking histories.  That particular surgery went well, and he recovered quickly.  However, the lung surgery that provided his best option, carried risks.  One of the main risks appeared within a day of his lobectomy.  Some clot had broken loose and raced straight for the recently repaired carotid, and blocked the artery.  The result, my father suffered two strokes.

It has been a long summer for my father.  He has recovered well from his surgery and strokes, with only the restriction of driving his only frustration.  But now he faces a crossroad.  His doctors are pressing him to consider preventative chemotherapy to take care of any stray cancer cells that may have been missed during the surgery.  As of yet, he is still not convinced that he needs to undergo chemotherapy.  There is no solid proof that there are any remaining cancer cells.  There is no support to show that his body can tolerate his cancer treatments.  On at least two occasions now, he has asked for the simplest of requests, just to know if there is the chance that he will suffer any more strokes during his treatments.

He must decide, to ignore the doctor’s recommendations to prevent the cancer from coming back, or be willing to accept that he may suffer another stroke or other health malady.

Then And Now – Final Day Of Treatment


Today’s post is dedicated to a young man in Southern Florida.  I am not using his name to protect his privacy.  I have never met this “kid” in person (at age 23 he is just a kid), only through the internet.  He was diagnosed with Hodgkin’s Lymphoma, just as I, at around the same age as I.  I learned of him as he was completing his second or third treatment.  Tomorrow, he will receive his last treatment.  I will be anxious to hear of his every moment from the impressive milestone.

The day had finally arrived.  It was a week late because the prior week, my blood counts were too low.  The option was to modify the chemo for that week, or delay the treatment a week and see how I feel, or just cancel the treatment all together.  The doctors decided that it was best for me to delay my treatment for one week.  I had done so well up to this point, had gone through 7 1/2 cycles.  I needed this one last set of infusions, and I would have solidified my chances of surviving Hodgkin’s Lymphoma.

That Friday, March 3, 1990 began just like the other Fridays of treatment.  I would go into the oncology office, by myself.  My name would be called twice.  The first time was to do bloodwork and confirm that I could handle going through the final treatment.  I had been cleared.

The second time that my name had been called, it was to walk back to the chemotherapy suite.  As usual, my oncology nurse Brenda was busy setting up all of the syringes.  I sat down in the chair and began to roll up my sleeves.  I was not sure which arm would be used.  I just know that my veins had been destroyed by all of the chemicals that had been used to save my life.

Brenda turned around, looked at me and asked, “you ready?  You have finally gotten here, the end.  This could not have been easy for you.  These are such hard drugs to use.”  I gave her an agreeing nod, and like that, she had already stuck the needle into my arm.  Half of the cycle resulted me dealing with nausea, the second half, did not give me any problems.

And so over the next hour, I received my final treatment.

After the last drip, Brenda began the process of removing the catheter from my arm.  “Now Paul, when you get up from this chair, you have to imagine that there is a marching band playing for you, in triumph.”  My eyes lit up and all of a sudden, I could “hear” the band as I walked down that long hall from the chemo suite, for what I was determined to be the last time.

With the internet today, over 23 years later, internet support groups now make a daily post announcing those who are completing their treatments.  And today, there are pictures of these milestone.  Someone is either holding a sign announcing the date and the event, or many hospitals have a huge bell that is rung each time a patient completes their treatment.  Even more impressive, is that every day, people join the millions of cancer survivors, MILLIONS!  Unlike 23 years ago, I know many of these survivors.

Tomorrow, my friend will complete his treatment, twelve cycles, countless injections.  This is no easy fete for anyone to accomplish.  The physical toll is nothing compared to what the mental toll can take through the whole experience.  From the fear of death, to the frustrations of having ups and downs, and no way to control them, the emotional toll can be brutal.  He was blessed during this journey with having the strongest support than I can ever recall.  As I went through my battle, I remember often the times that I said “I wish I was younger so that my parents could have made the decisions about this cancer for me”.  His mother has been by his side from the first moment.  As a parent myself, I cannot imagine having either of my children have to face such a disease.

But Dude, you have done it!  You have gotten to your final treatment.  You have done it with courage, strength, and determination.  The support of your mother, sister, grandparents clearly played a roll in beating this cancer.  Tomorrow is your day.  Congratulations and this is for you…

“As I continue down the road of remission, I will keep looking in my rear view mirror to make sure that you are still following me.”  This is a quote that I often write to many who recognize such milestone days in their battles with cancer.

It is over 23 years for me.  I wish you the same lengthy and healthy longevity that I have experienced.  Good luck tomorrow.

Your friend, Paul

The Dentist


Being diagnosed with cancer and having to go through chemotherapy, pretty scary, right?  Having to undergo open heart bypass surgery… definitely scary, right?  But going to the dentist, the anxiety produced is more than the total I felt between the cancer and heart surgery combined.  That is right, up until one point, I was more terrified of going to the dentist than when I had gone through cancer treatments and laying on the table next to the machine that would keep my body alive while the bypasses were performed.  And believe it or not, there actually is one good reason to be concerned about going to the dentist, but not what you think.  My reasons for delaying my appointments bordered on ridiculous.

My earliest memories of the dentist were not too bad.  Sure I had cavities, but Dr. Weaver was good working with kids.  My first reaction to receiving novacaine did not go well as I reacted like an eight year old might, legs thrashing about in pain.  A little nitrous oxide took care of that.  To make sure that the laughing gas had taken effect, I remember Dr. Weaver taking aim at an airplane mobile hanging from the ceiling in the corner, with his water gun which would be used to irrigate my mouth as needed.  But in the years that followed, I had no issues with getting to the dentist, or having cavities.

But somewhere along the road, a fear, and anxiety developed.  I cannot even explain it, but it led to me not being seen for over six years.  And even then, I had gone through two more dentists due to the fact that I had moved to a new city, plus, that same anxiety was becoming an issue.  I cannot say that at that point, my long term cancer survival issues had played any role, because those late developing side effects had not appeared.

In 2008, eighteen years after my diagnosis of Hodgkin’s Lymphoma, I faced open heart surgery.  All went well, and I was introduced to the world of long term cancer survivors and the many issues that many face due to the toxicity of what we were treated with.  I had broken a tooth.  I knew I needed to get seen before anything went wrong, such as an infection, so made the call to a local dental office.  It was during this appointment that I met Dr. P.  She is a young woman, but very skilled, knowledgable, and empathic with her care.  She had advised me on the risks I face, sepsis with the abscess that had been discovered examining the broken tooth.  An infection in the blood (sepsis) traveling to the heart, can be fatal, possibly within hours of being discovered.  To make matters worse, from my diagnostic plan in 1988, my spleen was removed to see if I had signs of Hodgkin’s Lymphoma in the spleen.  This procedure left me “asplenic” which means that I cannot fight off infections, or as well as a normal person.  She had mentioned root canal for this tooth due to an abscess, followed by a crown.  My anxiety level hit the roof, and out the door I went as I decided to just have the tooth pulled as this was going to be needed to be done by an oral surgeon.

Following the tooth extraction, despite knowledge of how important good dental hygiene is, especially to a heart patient, I made a conscious decision not to return to the dentist for regular check ups.  I had done a lot of reading concerning the issues of not just asplenic or cardiac issues, but how frequently heart issues are discovered just by going to the dentist.  Simply put, if you are someone who does not floss regularly (and who has not gone to the dentist and not been asked or told to floss regularly), it is not just the risk of gingevitus developing, but the bacteria could just end up in your bloodstream, leading to sepsis.  Septic shock is fatal if not caught soon enough.

It had been a couple of months past the six month check-up window that had been assigned to me.  I just kept delaying the appointments.  Then something strange happened, and often.  Until I finally relented the phone calls kept coming.  It was Dr. P calling personally to follow up on me, and the importance that I get into her office to be seen, regularly.  To make sure that I understood her sincerity, she hit me where it would make me pay the most attention.

Dr. P. acknowledged my late term side effects, and the concerns with the jaw, mouth, and teeth due to the various treatments I had received for my Hodgkin’s.  She stressed that it was important that I come in for the regular cleaning and check-up.  I actually lost count on how many times she called me personally.  But Dr. P. was not going to give up.

When I finally made the decision to come into her office for the cleaning and check-up, Dr. P. took the first half hour of my appointment, just listening to me.  Listening to me babble on about my irrational anxiety about going to the dentist.  In what may have been her last opportunity, she began a discussion about pain management.

When you get a tooth cavity filled or the tooth itself pulled, the dentist has various means to numb the nerves and surrounding gum area to eliminate or minimalize the pain.  Dr. P. does not use nitrous oxide, but she does use Ambesol along with novacaine.  The Ambesol topically numbs the gum area to be injected.  The novacaine will do the rest.  But what if you have not been given enough novacaine?  You ask for more.  The chances are probably close to 99% that you can have a booster of novacaine, in fact, several boosters if that does not work.

It has been three years since Dr. P. convinced me she was not to be stressed about.  During a recent visit to have a cavity filled, my gum was not cooperating and it took seven stabs of the novacaine before she could proceed to fill my tooth.  But she took that time.  I trusted her.  I think I am finally over my dental anxiety.  As a cancer survivor exposed to radiation therapy to my lower jaw, the structure of my upper and lower jaws is crucial.  And she knows that.

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